Example: quiz answers

A. Artemether-lumefantrine (CoartemTM resistance

1 Malaria in the United States: Treatment Tables CDC Malaria Hotline: (770) 488-7100 or (855) 856-4713 (toll free) Mon Fri, 9 am 5 pm EST; (770) 488-7100 after hours, weekends, and holidays Table 1. Uncomplicated malaria: Plasmodium falciparum or unknown species1,2,3 (If later diagnosed as P. vivax or P. ovale, see Table 2 for antirelapse treatment) Drug Susceptibility (Based on where acquired) Recommended Adult Regimens Recommended Pediatric Regimens4 Chloroquine resistant or unknown resistance (All malaria-endemic regions except those in Central America west of Panama Canal, Haiti, and Dominican Republic) A. Artemether-lumefantrine (CoartemTM)5 (1 tab: 20 mg artemether and 120 mg lumefantrine) Adults: 4 tabs po per dose Three-day course: Day 1: Initial dose and second dose 8 h later Days 2 and 3: 1 dose BID B.

week) for 8 weeks with close monitoring for hemolysis. Those with G6PD deficiency may be given chloroquine 300 mg (base) po weekly for 1 year from acute infection to prevent relapses. 7 Primaquine and tafenoquine must not be used during pregnancy; pregnant patients with P. vivax and P. ovale infections should receive chloroquine 300

Tags:

  Monitoring

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of A. Artemether-lumefantrine (CoartemTM resistance

1 1 Malaria in the United States: Treatment Tables CDC Malaria Hotline: (770) 488-7100 or (855) 856-4713 (toll free) Mon Fri, 9 am 5 pm EST; (770) 488-7100 after hours, weekends, and holidays Table 1. Uncomplicated malaria: Plasmodium falciparum or unknown species1,2,3 (If later diagnosed as P. vivax or P. ovale, see Table 2 for antirelapse treatment) Drug Susceptibility (Based on where acquired) Recommended Adult Regimens Recommended Pediatric Regimens4 Chloroquine resistant or unknown resistance (All malaria-endemic regions except those in Central America west of Panama Canal, Haiti, and Dominican Republic) A. Artemether-lumefantrine (CoartemTM)5 (1 tab: 20 mg artemether and 120 mg lumefantrine) Adults: 4 tabs po per dose Three-day course: Day 1: Initial dose and second dose 8 h later Days 2 and 3: 1 dose BID B.

2 Atovaquone-proguanil (MalaroneTM)6 (Adult tab: 250 mg atovaquone and 100 mg proguanil) 4 adult tabs po QD x 3 days A. Artemether-lumefantrine (CoartemTM)5 (1 tab: 20 mg artemether and 120 mg lumefantrine) 5 <15 kg: 1 tab po per dose 15 <25 kg: 2 tabs po per dose 25 <35 kg: 3 tabs po per dose 35 kg: 4 tabs po per dose Three-day course: Day 1: Initial dose and second dose 8 h later Days 2 and 3: 1 dose BID B. Atovaquone-proguanil (MalaroneTM)6 (Adult tab: 250 mg atovaquone and 100 mg proguanil; Peds tab: mg atovaquone and 25 mg proguanil) 5 <8 kg: 2 peds tabs po QD x 3 days 8 <10 kg: 3 peds tabs po QD x 3 days 10 <20 kg: 1 adult tab po QD x 3 days 20 <30 kg: 2 adult tabs po QD x 3 days 30 <40 kg: 3 adult tabs po QD x 3 days 40 kg: 4 adult tabs po QD x 3 days 1 Abbreviations: QD=once a day, BID=twice a day, TID=three times a day, QID=four times a day, h=hour(s), po=by mouth, IV=intravenous, tab(s)=tablet(s).

3 2 If an antimalarial taken for chemoprophylaxis, a different drug should be used for treatment. 3 Option A preferred, Options B and C adequate alternatives and should be used if more readily available than Option A. Option D should be used only if other options not available. 4 Not to exceed adult dose. 5 Artemether-lumefantrine can be used in second and third trimesters of pregnancy and, if no other options available, in first trimester as well. Not for infants <5 kg or women breastfeeding infants <5 kg. 6 Atovaquone-proguanil not recommended during pregnancy, in infants <5 kg, or in women breastfeeding infants <5 kg. May be considered if other treatment options not available or not tolerated, and benefits outweigh risks.

4 2 Table 1. (continued) Uncomplicated malaria: P. falciparum or unknown species (If later diagnosed as P. vivax or P. ovale, see Table 2 for additional treatment needed) Drug Susceptibility (Based on where acquired) Recommended Adult Regimens Recommended Pediatric Regimens4 Chloroquine resistant or unknown resistance (All malaria-endemic regions except those in Central America west of Panama Canal, Haiti, and Dominican Republic) C. Quinine sulfate7 plus doxycycline8, tetracycline8, or clindamycin9 Quinine sulfate: 542 mg base (650 mg salt) po TID x 3 or 7 days7 Doxycycline: 100 mg po BID x 7 days Tetracycline: 250 mg po QID x 7 days Clindamycin: 20 mg/kg/day po divided TID x 7 days D.

5 Mefloquine10 Dose 1: 684 mg base (750 mg salt) po Dose 2 at 6 to 12 h: 456 mg base (500 mg salt) po C. Quinine sulfate7plus doxycycline8, tetracycline8, or clindamycin9 Quinine sulfate: mg base/kg (10 mg salt/kg) po TID x 3 or 7 days7 Doxycycline: mg/kg po BID x 7 days Tetracycline: 25 mg/kg/day po divided QID x 7 days Clindamycin: 20 mg /kg/day po divided TID x 7 days D. Mefloquine100 Dose 1: mg base/kg (15 mg salt/kg) po Dose 2 at 6 to 12 h: mg base/kg (10 mg salt/kg) po Chloroquine sensitive11 (Central America west of Panama Canal, Haiti, and Dominican Republic) Chloroquine phosphate (Aralen and generics) Dose 1: 600 mg base (1,000 mg salt) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 300 mg base (500 mg salt) po per dose.

6 Or Hydroxychloroquine (PlaquenilTM and generics) Dose 1: 620 mg base (800 mg salt) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 310 mg base (400 mg salt) po per dose Chloroquine phosphate (Aralen and generics) Dose 1: 10 mg base/kg ( mg salt/kg) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 5 mg base/kg ( mg salt/kg) po per dose; or Hydroxychloroquine (PlaquenilTM and generics) Dose 1: 10 mg base/kg ( mg salt/kg) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 5 mg base/kg ( mg salt/kg) po per dose 7 Quinine to be given for 3 days, except for infections acquired in Southeast Asia where 7 days of treatment required.

7 Quinine available in the US has 324 mg (salt) per capsule; therefore, 2 capsules for adult dosing. Pediatric dosing may need compounding pharmacy. 8 Doxycycline or tetracycline combined with quinine preferred due to more efficacy data, but not recommended during pregnancy or in children <8 years old unless no other options and benefits outweigh risks. 9 Clindamycin with quinine preferred option for pregnant women and children <8 years old. 10 Mefloquine not recommended for infections acquired in Southeast Asia due to drug resistance . Not recommended if other options available or in patients with neuropsychiatric history. 11 Regimens used to treat chloroquine-resistant P.

8 Falciparum infections may be used if chloroquine and hydroxychloroquine not available. 3 Table 2. Uncomplicated malaria: P. vivax or P. ovale1,2 Drug Susceptibility (Based on where acquired) Recommended Adult Regimen (BOTH acute and antirelapse treatments recommended) Recommended Pediatric Regimen3 (BOTH acute and antirelapse treatments recommended) Chloroquine sensitive (All malaria-endemic regions except Papua New Guinea and Indonesia) Acute treatment4: Chloroquine phosphate (Aralen and generics) Dose 1: 600 mg base (1,000 mg salt) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 300 mg base (500 mg salt) po per dose.

9 Or Hydroxychloroquine (PlaquenilTM and generics) Dose 1: 620 mg base (800 mg salt) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 310 mg base (400 mg salt) po per dose AND Antirelapse treatment5: Primaquine phosphate6,7,8 30 mg base po qd x 14 days; or Tafenoquine (KrintafelTM)6,7,9 300 mg po x 1 dose Acute treatment4: Chloroquine phosphate (Aralen and generics) Dose 1: 10 mg base/kg ( mg salt/kg) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 5 mg base/kg ( mg salt/kg) po per dose; or Hydroxychloroquine (PlaquenilTM and generics) Dose 1: 10 mg base/kg ( mg salt/kg) po Doses 2 to 4 (3 additional doses) at 6, 24 and 48 h: 5 mg base/kg ( mg salt/kg) po per dose AND Antirelapse treatment5: Primaquine phosphate6,7,8 mg base/kg po qd x 14 days; or Tafenoquine (KrintafelTM)6,7,9 300 mg po x 1 dose, only for patients 16 years old 1 Abbreviations: QD=once a day, BID=twice a day, TID=three times a day, QID=four times a day, h=hour(s), po=by mouth, IV=intravenous, tab(s)=tablet(s).

10 2 If an antimalarial taken for chemoprophylaxis, a different drug should be used for treatment. 3 Not to exceed adult dose. 4 Regimens used to treat chloroquine-resistant P. vivax infections may be used if chloroquine and hydroxychloroquine not available. 5 Either option for antirelapse treatment recommended if chloroquine or hydroxychloroquine used for acute treatment. If regimens other than either chloroquine or hydroxychloroquine used for acute treatment, primaquine is the only option for antirelapse treatment. 6 Primaquine and tafenoquine associated with hemolytic anemia in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency.


Related search queries